不同针刺方法对中风患者手痉挛影响的对比研究  

Comparative study on effects of different acupuncture manipulation methods at Neiguan (PC 6) on hand spasm in the patient of stroke

作　　者：王利春[1] 王志勇[1] 康西忠[1] 贾丽娟[1] 

机构地区：[1]河北医科大学附属沧州中西医结合医院神经内科,沧州061001

出　　处：《中国针灸》2008年第7期503-506,共4页Chinese Acupuncture & Moxibustion

摘　　要：目的:观察内关穴不同针刺手法治疗中风患者手部痉挛的疗效。方法:将172例患者随机分为单纯针刺组(36例)、慢速捻针组(34例)、快速捻针组(30例)、单纯提插组(35例)和提插捻转组(37例)。均取内关穴,每天针刺2次,每次5分钟,并配合康复训练。以修订的Ashworth量表和Fugl-Meyer(FMA)手功能评分评定疗效。结果:手痉挛即刻有效率和治疗8周后有效率单纯针刺组分别为66.7%、55.6%,慢速捻针组为82.4%、85.3%,快速捻针组为96.7%、90.0%,单纯提插组为80.0%、82.9%,提插捻转组为94.6%、91.9%,快速捻针组与提插捻转组疗效优于其他3组(P<0.01)。治疗后Ashworth量表分级和FMA评分提插捻转组、快速捻针组均优于其余3组(P<0.05,P<0.01),且提插捻针组和快速捻针组之间差异无显著性意义(P>0.05)。结论:针刺内关穴有非常肯定的即刻效应,提插捻转手法与快速捻转手法对痉挛的抑制效果最佳。Objective To observe therapeutic effects of different needling methods at Neiguan （PC 6） on hand spasm in the patient of stroke. Methods One hundred and seventy-two cases were randomly divided into a simple acupuncture group （n= 36）, a slowly twirling needle group （n= 34）, a rapidly twirling needle group （n= 30）, a simple lifting-thrusting group （n= 35） and a lifting-thrusting-twirling needle group （n = 37）. Acupuncture was given at Neiguan （PC 6）, twice each day, 5 min each time, and in combination with rehabilitation exercise. Modified Ashworth scale and Fugl-Meyer （FMA） hand function score were used for assessment of therapeutic effects. Results The transient effective rate and the effective rate after treatment for 8 weeks for hand spasm were 66.7% and 55.6% in the simple acupuncture group, 82. 4% and 85.3~ in the slowly twirling needle group,96.7% and 90.0% in the rapidly twirling needle group, 80. 0% and 82.9% in the simple lifting-thrusting group and 94.6% and 91.9% in the lifting-thrusting-twirling needle group, the rapidly twirling needle group and the lifting-thrusting-twirling needle group being better than other 3 groups （P〈0.01）. After treatment, the grades for Ashworth scale and FMA scores in the lifting-thrusting-twirling needle group and the rapidly twirling needle group were better than those in other 3 groups （P〈0. 05, P〈0.01 ）, with no significant difference between the two groups （P〉0.05）. Conclusion Acupuncture at Neiguan （PC 6） has a very definite transient effect, and the lifting-thrusting-twirling needling manipulation and the rapidly twirling needling manipulation have the best inhibitive effect on spasm.

关 键 词：穴 内关 中风后遗症/针灸疗法 肌痉挛/针灸疗法 针刺方向 

分 类 号：R246.6[医药卫生—针灸推拿学]